Intérêts des ponctions biopsies rénales percutanées dans la prise en charge des tumeurs solides du rein inférieures ou égales à 4cm

Rybikowski, S.; Tomatis, L.; Arroua, F.; Ragni, E.; Rossi, D.; Bastide, C.

doi:10.1016/j.purol.2008.03.024

Cited by 14 publications

(3 citation statements)

References 12 publications

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“…However, in 362 clinically diagnosed renal mass biopsies of the series performed in 2001 and later, the mean false-negative and false-positive results were 0.6% and 0%, respectively. Other studies evaluating the performance of biopsy in SRMs have also shown an accuracy rate of above 90% in discriminating malignancy [22,23,24,25,26,27,28,29]. …”

Section: Current Status Of Small Renal Mass Biopsymentioning

confidence: 99%

Current Status of Renal Biopsy for Small Renal Masses

Kwak

2014

Korean J Urol

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Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.

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Section: Current Status Of Small Renal Mass Biopsymentioning

confidence: 99%

Current Status of Renal Biopsy for Small Renal Masses

Kwak

2014

Korean J Urol

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“…Nonetheless, historic studies report a wide range of change in management (6.3–47.8%) based upon response to core biopsy results. Moreover, inconsistent definitions of “change in management” are so varied that it is often difficult to make meaningful conclusions from studies that evaluate this criteria (Rybikowski et al, 2008; Shannon et al, 2008; Thuillier et al, 2008). Yet, others have reported that RMB provided important information in determining which patients would be best for AS, NSS, or radical nephrectomy based upon indeterminate, benign, intermediate, or unfavorable histology (Tan et al, 2012).…”

Section: Problems With the Traditional View Of Renal Mass Biopsymentioning

confidence: 99%

The contemporary role of renal mass biopsy in the management of small renal tumors

Lim¹,

O’Neil²,

Heilbrun³

et al. 2012

Front. Oncol.

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The selective use of percutaneous biopsy for diagnosis in renal masses is a relatively uncommon approach when compared to the management of other solid neoplasms. With recent advancements in imaging techniques and their widespread use, the incidental discovery of asymptomatic, small renal masses (SRM) is on the rise and a substantial percentage of these SRM are benign. Recent advances in diagnostics have significantly improved accuracy rates of renal mass biopsy (RMB), making it a potentially powerful tool in the management of SRM. In this review, we will discuss the current management of SRM, problems with the traditional view of RMB, improvements in the diagnostic power of RMB, cost-effectiveness of RMB, and risks associated with RMB. RMB may offer important information enabling treating clinicians to better risk-stratify patients and ultimately provide a more personalized treatment approach for SRM.

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“…Of the 9 studies’ risk bias, 8/9 provided clear definition of an exclusion criteria, one study just described the basic information about subjects without exclusion criteria and thus scored “high risk”. Two studies ( 8 , 14 ) did not show enough information about the methods in details clearly, and also did not described an exact time of interval between the biopsies and follow-up of patients. Studies where language differences were thought to exist were scored ‘unclear’ in the index tests bias and patient flow and timing domains which we were not sure about in these studies.…”

Section: Resultsmentioning

confidence: 99%

Accuracy of Percutaneous Core Biopsy in the Diagnosis of Small Renal Masses (≤4.0 cm): A Meta-analysis

Wang

Kenyon

et al. 2015

Int. braz j urol.

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Objective To use meta-analysis to determine the accuracy of percutaneous core needle biopsy in the diagnosis of small renal masses (SMRs≤4.0 cm).Materials and Methods Studies were identified by searching PubMed, Embase, and the Cochrane Library database up to March 2013. Two of the authors independently assessed the study quality using QUADAS-2 tool and extracted data that met the inclusion criteria. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and also summary receiver operating characteristic (SROC) curve were investigated and draw. Deek’s funnel plot was used to evaluate the publication bias.Result A total of 9 studies with 788 patients (803 biopsies) were included. Failed biopsies without repeated or aborted from follow-up/surgery result were excluded (232 patients and 353 biopsies). For all cases, the pooled sensitivity was 94.0% (95% CI: 91.0%, 95.0%), the pooled positive likelihood was 22.57 (95% CI: 9.20-55.34), the pooled negative likelihood was 0.09 (95% CI: 0.06-0.13), the pooled DOR was 296.52(95% CI: 99. 42-884.38). The area under the curve of SROC analysis was 0.959±0.0254.Conclusion Imaging-guided percutaneous core needle biopsy of small renal masses (SMRs≤4.0 cm) is highly accurate to malignant tumor diagnosis with unknown metastatic status and could be offered to some patients after clinic judgment prior to surgical intervention consideration.

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Intérêts des ponctions biopsies rénales percutanées dans la prise en charge des tumeurs solides du rein inférieures ou égales à 4cm

Cited by 14 publications

References 12 publications

Current Status of Renal Biopsy for Small Renal Masses

Current Status of Renal Biopsy for Small Renal Masses

The contemporary role of renal mass biopsy in the management of small renal tumors

Accuracy of Percutaneous Core Biopsy in the Diagnosis of Small Renal Masses (≤4.0 cm): A Meta-analysis

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